Ilene Caryn Simon, MSW, MPH, PHD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14111 Issued in CA

Practice address

1626 Westwood Blvd Ste 102
Los Angeles, CA 90024-5621

Phone

(310) 470-7957

NPI assigned

Jan 27, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ilene Caryn Simon Solomon Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2020 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1881925113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 WESTWOOD BLVD STE 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245621",
            "telephone_number": "310-470-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 WESTWOOD BLVD STE 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245621",
            "telephone_number": "310-470-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "ILENE",
        "middle_name": "CARYN",
        "name_prefix": "Dr.",
        "credential": "MSW, MPH, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "14111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILENE",
            "last_name": "SIMON SOLOMON",
            "middle_name": "CARYN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chris Stevens Simon, PHYSICAL THERAPIST
• Cindy M Simon
• Deborah Simon, PH.D.
• Donna Bayer Simon, MSW LCSW
• Eva Simon
• Jacqueline Medina Simon
• James Simon V
• James David Simon, ASW
• Jean Michele Simon, MA, LMFT
• Julie M Simon, MA MBA MFT

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.